9例以肝功能异常起病的恶性淋巴瘤患者临床特征分析

doi:10.3969/j.issn.1672-5069.2020.05.012

摘要/Abstract

摘要： 目的总结因肝功能异常就诊并确诊为恶性淋巴瘤患者的病例资料,分析其临床特征,以提高临床诊断和鉴别能力。方法采用回顾性分析法总结患者的临床表现、影像学特点、病理学检查和治疗转归。结果 9例患者年龄为48.47±16.02(16～78)岁;8例主诉乏力,3例发热,5例皮肤和巩膜黄染;化验示ALT 192.3±292.8U/L,AST 192.6±222.9U/L,TBIL 120.4±89.5μmol/L;7例腹部影像学提示肝脾增大;骨髓穿刺5例,肝脏穿刺2例,淋巴结检查2例,胃黏膜病理1例,均提示B细胞来源淋巴瘤;6例接受药物化疗,3例死亡,3例失访,3例规律化疗过程中。结论肝功能异常患者合并不明原因肝脾增大时,需考虑恶性淋巴瘤的可能,及时行肝脏和/或骨髓病理学检查可帮助明确诊断。

关键词: 肝功能异常, 淋巴瘤, 临床特征, 文献复习 , ,

Abstract: Objective The aim of this study was to summarize the clinical features of patients with malignant lymphoma (ML) and liver dysfunction. Methods The clinical manifestations, imaging features, pathological findings and clinical outcomes were summarized by retrospective analysis. Results The age of 9 patients was 48.47±16.02 (16～78) years; 8 complained of asthenia, 3 had fever, 5 had yellow skin and eye; serum ALT level was 192.3±292.8 u/l, AST was 192.6±222.9 U/L, serum bilirubin level was 120.4±89.5μmol/L; 7 had liver and spleen enlargement; bone marrow biopsies were performed in 5 cases, liver biopsies were in 2 cases, lymph node examination in 2 cases and gastric mucosa pathology in 1 case, all of which indicated B-cell-arose lymphoma; chemotherapy were given in 6 cases and 3 cases died, and 3 cases received regular chemotherapy and followed-up. Conclusions It is necessary to consider the possibility of ML in patients with abnormal liver function and unexplained hepatosplenomegaly. The pathological examination of liver and/or bone marrow could help the confirmation of the diagnosis.

Key words: Liver dysfunction, Lymphoma, Clinical features, Literature review

刘松涛, 李娟, 于红卫, 侯维, 胡中杰. 9例以肝功能异常起病的恶性淋巴瘤患者临床特征分析[J]. 实用肝脏病杂志, 2020, 23(5): 650-653.

Liu Songtao, Li Juan, Yu Houwei, et al.. Clinicalfeatures of nine patients with malignant lymphoma and liver injury[J]. Journal of Practical Hepatology, 2020, 23(5): 650-653.

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